血压变异性与急性脑梗死患者预后的相关性分析

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摘要目的分析血压变异性（BPV）与急性脑梗死3个月预后的关系。方法选取2018年11月～2019年4月于合肥市滨湖医院（以下简称“我院”）神经内科住院的急性脑梗死患者42例为急性脑梗死组，研究终点为发病后3个月，选取我院门诊同期健康体检者32名为对照组。比较两组BPV参数，包括24 h收缩压变异系数（24hSBPcv）、24 h舒张压变异系数（24hDBPcv）、日间收缩压变异系数（dSBPcv）、日间舒张压变异系数（dDBPcv）、夜间收缩压变异系数（nSBPcv）、夜间舒张压变异系数（nDBPcv）、24 h收缩压标准差（24hSSD）、24 h舒张压标准差（24hDSD）、日间收缩压标准差（dSSD）、日间舒张压标准差（dDSD）、夜间收缩压标准差（nSSD）、夜间舒张压标准差（nDSD）。采用线性回归分析不同BPV参数与急性脑梗死3个月预后的关系。结果两组性别、年龄、高血压病史、糖尿病史、吸烟史、饮酒史、心房颤动病史比较，差异无统计学意义（P ＞ 0.05）。两组三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平比较，差异无统计学意义（P ＞ 0.05）。急性脑梗死组nSBPcv、24hSSD、24hDSD、dSSD、nSSD明显高于对照组，差异有统计学意义（P ＜ 0.05）。两组24 h动态血压昼夜节律情况比较，差异有统计学意义（P ＜ 0.05）。24hSBPcv、dSBPcv、24hSSD、dSSD与脑梗死3个月后预后相关（P ＜ 0.05）。结论 BPV是脑梗死预后的重要影响因素，急性脑梗死患者24hSSD、dSSD、24hdSBPcv、dSBPcv与3个月预后相关。

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	宋道辉席春华▲ 穆燕芳张留福张婷婷

关键词 ：血压变异性, 血压监测, 脑梗死, 昼夜节律

Abstract：Objective To analyze the relationship between blood pressure variability (BPV) and 3-month prognosis of acute cerebral infarction. Methods From November 2018 to April 2019, 42 patients with acute cerebral infarction in Department of Neurology of Hefei Binhu Hospital (“our hospital” for short) were selected as acute cerebral infarction group, and the end point was 3-month after the onset of the disease. Meanwhile, 32 persons taken healthy physical examination in Outpatient Department of our hospital were selected as control group. Parameters of blood pressure variability between two groups were compared, including 24-hour systolic blood pressure coefficient of variation (24hSBPcv), 24-hour diastolic blood pressure coefficient of variation (24hDBPcv), daytime systolic blood pressure coefficient of variation (dSBPcv), daytime diastolic blood pressure coefficient of variation (dDBPcv), nocturnal systolic blood pressure coefficient of variation (nSBPcv), nocturnal diastolic blood pressure coefficient of variation (nDBPcv), 24-hour systolic blood pressure standard deviation (24hSSD), 24-hour diastolic blood pressure standard deviation (24hDSD), daytime systolic pressure standard deviation (dSSD), daytime diastolic pressure standard deviation (dDSD), nighttime systolic pressure standard deviation (nSSD) and nighttime diastolic pressure standard deviation (nDSD). Linear regression was used to analyze the correlation between 3-month prognosis of acute cerebral infarction and different blood pressure variability parameters. Results There was no significant difference in gender, age, history of hypertension, diabetes, smoking, drinking and atrial fibrillation between two groups (P > 0.05). The levels of triacylglycerol, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol between two groups were compared, with no significant difference (P > 0.05). The nSBPcv, 24hSSD, 24hDSD, dSSD and nSSD of acute cerebral infarction group were higher than those of control group, the differences were statistically significant (P < 0.05). 24-hour ambulatory blood pressure circadian rhythm of two groups was significantly different (P < 0.05). 24hSBPcv, dSBPcv, 24hSSD and dSSD were correlated with prognosis after 3-month of cerebral infarction (P < 0.05). Conclusion BPV is an important factor in the prognosis of cerebral infarction. 24hSSD, dSSD, 24hdSBPcv and dSBPcv in patients with acute cerebral infarction are related to the prognosis of 3-month.

Key words： Blood pressure variability Blood pressure monitoring Cerebral infarction Circadian rhythm

基金资助:国家自然科学基金资助项目（81301095）；
安徽省合肥市卫计委应用医学研究项目（自筹）（hwk2018zc003）。

通讯作者: ▲通讯作者

引用本文:

宋道辉席春华▲ 穆燕芳张留福张婷婷. 血压变异性与急性脑梗死患者预后的相关性分析[J]. 中国医药导报, 2020, 17(11): 65-68.
SONG Daohui XI Chunhua▲ MU Yanfang ZHANG Liufu ZHANG Tingting. Analysis of correlation between blood pressure variability and prognosis of patients with acute cerebral infarction. 中国医药导报, 2020, 17(11): 65-68.

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